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Advanced surgical sperm recovery is a viable option for intracytoplasmic sperm injection in patients with obstructive
K Jaroudi1, S Coskun, J Hollanders
1Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. jaroudi@kfshrc.edu.sa
Objective:
To determine whether advanced sperm retrieval is appropriate in cases of obstructive and nonobstructive azoospermia.
Design:
Prospective controlled study.
Setting:
Tertiary care center.
Patient(S):
Men with obstructive and nonobstructive azoospermia, and their partners.
Intervention(S):
Surgical sperm retrieval followed by intracytoplasmic sperm injection (ICSI) after 4 or 48 hours.
Main Outcome Measure(S):
Fertilization and pregnancy rates.
Result(S):
Advanced and fresh surgical sperm recoveries for ICSI were performed in 54 and 230 cycles, respectively. Patient demographics and cycle parameters were comparable. Two hundred forty-one (56.3%) of 428 injected eggs in the advanced retrieval group were fertilized, compared with 955 (56.6%) of 1,686 eggs in the fresh retrieved group (P=.94). There was no statistically significant difference in the pregnancy rates per ET between groups: 38.2% (18 of 47) in the advanced retrieval group and 39.9% (73 of 183) in the fresh sperm recovery group (P=.97).
Conclusion(S):
Testicular and epididymal sperm recovery can be safely performed 48 hours before ICSI. This facilitates planning, and, in cases of failure to retrieve sperm, hCG administration and ovum pick-up can be canceled, thereby reducing costs and eliminating the risk of ovarian hyperstimulation.